Organization
WEST DERMATOLOGY OF NORTHERN CALIFORNIA, INC
Active
Organization
WEST DERMATOLOGY OF NORTHERN CALIFORNIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J ROBERT WEST SR. M.D. (PRESIDENT)
(909) 335-8649
Entity
Organization
Contact information
Practice address
1444 FLORIDA AVE, SUITE 201, MODESTO, CA 95350-4400
(209) 526-4384
(209) 526-4385
Mailing address
101 E REDLANDS BLVD, SUITE 212, REDLANDS, CA 92373-4775
(909) 335-8649
(909) 335-1994
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF6859
RAILROAD MEDICARE
CA
Enumeration date
12/12/2006
Last updated
08/01/2008
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